O5-7 Feasibility Study- A physiotherapy led remote ACHD Cardiac Rehabiliation Program

Abstract Problem Prevalence of adult congenital heart disease (ACHD) is growing. Exercise is safe and effective at enhancing exercise capacity and quality of life (QOL) for ACHD patients but they are predominately sedentary with reduced exercise capacity and obese compared to peers. ACHD patients are concerned about their inactivity, however are uncertain of exercise suitability and safety and are unable to access specialist advice or cardiac rehabilitation (CR). Many ACHD patients are managed in specialist centres covering vast areas meaning classes are inappropriate. Acquired heart disease CR is cost-effective, improving QOL, exercise capacity, mortality and morbidity. ACHD patients potentially gain the same benefits. Remote cardiac rehabilitation (RCR) using technology could be a feasible model providing accessible specialist knowledge and individualised exercise prescription. Description of the problem Cardiologists referred sedentary, complex ACHD patients for a 12-week RCR providing individualised exercise prescription, education and motivation via telephone clinics and free apps (PT Momentum, Pacer and Active 10). Initially, habitual exercise was encouraged, participants were coached to achieve the recommended UK PA guidelines. Self-efficacy for Exercise (SEE) and Satisfaction with Life Score (SWLS) were assessed comparing patients' responses upon program completion to baseline. To determine the feasibility and acceptability of RCR to ACHD patients and quanitfy the impact of RCR on patient's physical activity (PA) and QOL. To discover if technology supported programme can increase the PA level of ACHD patients. Results From 23 referrals, 11 completed the program becoming more physically active, fulfilling the guidelines. Improvements were seen in both SEE (mean 30) and SWLS (mean 10). Patients deemed RCR an acceptable service delivery. Participants (9) responded well to apps. Reasons for not using apps included data capacity (1) or no device (2). Lessons ACHD patients engaged with RCR making it; viable, acceptable and practical solution improving PA levels and QOL. RCR using app's is a feasible model however, alternatives are required. Main Messages RCR enables ACHD patients to receive specialist knowledge, individualised, accessible and effective exercise prescription improving QOL and PA levels. RCR potentially leads to substantial cost savings and improvements in morbidity and mortality of ACHD patients.


Background
In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) does not have similar beneficial health effects. These differential health effects, also known as the physical activity health paradox, might be explained by dissimilar effects of LTPA and OPA on cardiorespiratory fitness (CRF). This study aims to investigate the association between deviceworn measures of physical behaviors during both work and leisure time and CRF among workers with high level of OPA.

Methods
Our results are based on a sample of 309 workers employed within the service and production sector from the crosssectional FEPA (Flemish Employees' Physical Activity) study. OPA and LTPA were measured using two Axivity AX3 accelerometers, worn on the back and right thigh for 2 to 4 consecutive working days. CRF levels were obtained by the Harvard step test. Compositional multiple linear regression analyses were used to analyze the relations, adjusted for age, sex, education, smoking, BMI, moderate-to vigorous physical activity (MVPA), and physical work demands.

Results
During work time, more sedentary behavior (SB) was associated with higher CRF when compared relatively to time spent on other work behaviors, while more SB during leisure time was associated with lower CRF when compared to other leisure time behaviors. Reallocating more time to MVPA from the other behaviors within leisure time was positively associated with CRF, which was not the case for MVPA during work.

Conclusion
Our results emphasize the need for taking the domain-specific nature of physical activity into account to understand its relation to CRF. Guidelines usually do not differentiate between OPA and LTPA in their recommendation to participate in at least 150 min of physical activity per week, regardless of the OPA level. Workers already meeting this recommendations through OPA might therefore mistakenly think that they already meet the recommendations on physical activity and think they can spend their leisure time in a sedentary fashion. In reality, these types of workers might benefit from recommendations to take more sitting breaks during their work and to participate in leisure time MVPA to Abstract citation ID: ckac094.039 O5-7 Feasibility Study-A physiotherapy led remote ACHD Cardiac Rehabiliation Program Caroline Evans 1 , Alan Graham Stuart 1 1 Cardiology, Bristol Heart Institute, Bristol, United Kingdom Corresponding author: graham.stuart@nhs.net

Problem
Prevalence of adult congenital heart disease (ACHD) is growing. Exercise is safe and effective at enhancing exercise capacity and quality of life (QOL) for ACHD patients but they are predominately sedentary with reduced exercise capacity and obese compared to peers. ACHD patients are concerned about their inactivity, however are uncertain of exercise suitability and safety and are unable to access specialist advice or cardiac rehabilitation (CR). Many ACHD patients are managed in specialist centres covering vast areas meaning classes are inappropriate. Acquired heart disease CR is costeffective, improving QOL, exercise capacity, mortality and morbidity. ACHD patients potentially gain the same benefits. Remote cardiac rehabilitation (RCR) using technology could be a feasible model providing accessible specialist knowledge and individualised exercise prescription. Description of the problem Cardiologists referred sedentary, complex ACHD patients for a 12-week RCR providing individualised exercise prescription, education and motivation via telephone clinics and free apps (PT Momentum, Pacer and Active 10). Initially, habitual exercise was encouraged, participants were coached to achieve the recommended UK PA guidelines. Self-efficacy for Exercise (SEE) and Satisfaction with Life Score (SWLS) were assessed comparing patients' responses upon program completion to baseline. 1. To determine the feasibility and acceptability of RCR to ACHD patients and quanitfy the impact of RCR on patient's physical activity (PA) and QOL. 2. To discover if technology supported programme can increase the PA level of ACHD patients.

Results
From 23 referrals, 11 completed the program becoming more physically active, fulfilling the guidelines. Improvements were seen in both SEE (mean 30) and SWLS (mean 10). Patients deemed RCR an acceptable service delivery. Participants (9) responded well to apps. Reasons for not using apps included data capacity (1) or no device (